Diabetes Health

Obesity a Factor in Increasing Numbers of Type 2 Diabetes Cases

The rate of new cases of type 2 diabetes has nearly doubled in the United States in the last decade, with most new cases appearing in southern states, says a Centers for Disease Control and Prevention (CDC) report.

New diagnoses of type 2 diabetes rose from 4.8 per 1,000 people from 1995 to 1997 to 9.1 per 1,000 people from 2005 to 2007.

These new cases mirror the increase in obesity rates, and obesity is a leading cause of the blood sugar disease.

"The risk factors for type 2 diabetes include obesity and inactivity, and we know the South has a high prevalence of both obesity and physical inactivity when compared to the other regions in the United States," says study author Karen Kirtland, Ph.D., at the CDC.

"The message that we want to get out is to promote lifestyle interventions for people who are at risk for diabetes," Dr. Kirtland says. "People who are at risk for the disease may be able to delay it or prevent it by losing weight, being physically active, and making healthy food choices."

Southern States Have High Rate

Publishing in CDC's Morbidity and Mortality Weekly Report, Dr. Kirtland's group used the CDC's Behavioral Risk Factor Surveillance System to collect data on new diabetes cases in 33 states that reported data for both time periods.

The researchers say the state-by-state breakdown, the first of its kind, found that new cases of diabetes ranged from a low of five per 1,000 people in Minnesota to 12.7 per 1,000 in West Virginia.

The territory of Puerto Rico had the largest number of new cases at 12.8 per 1,000 people.

The highest numbers of new type 2 diabetes cases were in Alabama, Florida, Georgia, Kentucky, Louisiana, South Carolina, Tennessee, Texas, and West Virginia.

An estimated 23.6 million American adults and children have diabetes, but almost one-quarter of them are unaware they have the disease. In 90 percent to 95 percent of cases, people have type 2 disease.

Dr. David L. Katz, director of the Yale University School of Medicine's Prevention Research Center, says reversing the obesity epidemic is key to cutting the rate of type 2 diabetes.

"We have known for some time that type 2 diabetes is a worsening epidemic in the United States and much of the world," notes Dr. Katz. "We now have evidence that the rate at which new cases of diabetes are developing is also increasing."

Dr. Katz says that southern states tend to have more poor people than other sections of the country, a statistic that could contribute to the greater number of new diabetes cases in that region.

"This is unsurprising, as obesity and poverty are strongly associated, and obesity is the predominant risk factor for type 2 diabetes," he says.

Medications Add to Treatment Expense

The new report could have frightening implications for future generations of Americans, says Dr. Katz.

"With the entire adult population of the United States projected to be overweight or obese by 2048, should current trends persist, diabetes is a clear and present danger to us all,” he says. “That threat will persist and worsen, until we resolve to turn back the tide of epidemic obesity.”

As the number of type 2 diabetes cases increase, so does the cost of treating the disease. Reporting in the Oct. 27 issue of Archives of Internal Medicine, researchers said the overall cost of drugs for type 2 diabetes almost doubled between 2001 and 2007.

Yet, it is not clear if newer medications improve patient care and results, the researchers say.

Type 2 diabetes is a lifelong disease caused by the body's inability to properly use the hormone insulin to transport sugar from the blood to cells for use as energy.

African Americans, Hispanics, Native Americans, and Asian Americans/Pacific Islanders are more prone to type 2 diabetes, as are persons with a family history of the disease, according to the National Institutes of Health (NIH).

January 2009

Understanding Obesity

Overweight and obesity together represent the second leading preventable cause of death in the United States.

Obesity is a serious, chronic disease that can inflict substantial harm to a person’s health. Overweight and obesity are not the same; rather, they are different points on a continuum of weight ranging from being underweight to being morbidly obese.

The percentage of people who fit into these two categories, overweight and obese, is determined by Body Mass Index (BMI).

The US Surgeon General has declared that overweight and obesity have reached epidemic proportions in this country. Over 12.9 million children between the ages of six and 19 are overweight.

Public health officials say physical inactivity and poor diet are catching up to tobacco as a significant threat to health. Currently, about 34 percent of women and 27 percent of men are considered obese.

BMI is a measure of weight proportionate to height. BMI is considered a useful measurement of the amount of body fat.

Occasionally, some very muscular people may have a BMI in the overweight range. However, these people are not considered overweight because muscle tissue weighs more than fat tissue. Generally, BMI can be considered an effective way to evaluate whether a person is overweight or obese.

According to the National Heart, Lung, and Blood Institute (NHLBI), a BMI from 18.5 to 24.9 is considered normal while a BMI of more than 25 is considered overweight.

A person is considered obese if the BMI is greater than 30 and morbidly obese if the BMI is 40 or greater. In general, after the age of 50, a man’s weight stabilizes and even drops slightly between the ages of 60 and 74. However, a woman’s weight continues to increase until age 60 and then begins to drop.

Another measure of obesity is the waist-to-hip ratio (WHR). The WHR is a measurement tool that looks at the proportion of fat stored on the waist, and hips and buttocks.

The waist circumference indicates abdominal fat. A waist circumference over 40 inches in men and over 35 inches in women may increase the risk for heart disease and other diseases associated with being overweight.

Consult your physician with questions regarding healthy body weight.

Always consult your physician for more information.

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